Without limiting the scope of the disclosed compositions and methods, the background is described in connection with a novel Sm-p80-based vaccine formulation against Schistosoma mansoni. 
Schistosoma mansoni is a flatworm parasite that inhabits the porto-mesenteric circulation of humans. Considerable morbidity and mortality results from the affliction of an estimated 207 million people worldwide by several species of schistosomes. An additional 779 million people are at risk of acquiring this infection. Disability-adjusted life years for schistosomiasis have been calculated to be somewhere between 1.7 million and 4.5 million years. Schistosomiasis is endemic in 74 developing countries.
The infective cycle of Schistosoma mansoni involves asexual reproduction within an intermediate snail host, followed by infection of a human host. Cercariae, the larval stage which exits from an intermediate snail host, infect humans by penetrating human skin. These juvenile schistosomes mature to schistosomula, undergo an intricate migration through the host's lungs and liver, and develop into sexually mature egg-laying adults. Sexually mature male and female schistosomes begin the egg-laying phase of the life cycle within the intestinal venules. The constant production of large numbers of ova results in the excretion of some eggs with fecal matter, and in heavy infection, entrapment of eggs in visceral organs with ensuing host granulomatous immune responses directed against them. It is this egg-induced organ damage which results in complications such as hepatic fibrosis, portal hypertension, and esophageal varices, which lead to the death of chronically infected hosts.
The chronic nature of this debilitating disease results in cumulative damage to the liver, spleen, and colon due to the granulomatous reaction to accumulated embryonated eggs. Infection results in the production of circulating anti-schistosomal antibodies. The immune response is erratic, however, and does not lead to sterile immunity. Additionally, the adult parasites evade immune clearance by complex and multifactorial mechanisms.
Emphasis has been placed on chemotherapy as the preferred method for the treatment of schistosomiasis. Control programs based on chemotherapy are complicated, however, by the rapidity and frequency of re-infection and the difficulties and expense involved in maintaining these programs over a long term. The continuous drug treatment and re-infection cycle fails to reduce the overall egg output sufficiently to markedly reduce transmission of the disease in endemic areas. Additionally, concerns exist that the parasites may develop drug resistance. A critical need remains for the development of alternate approaches to control the disease.
No effective vaccine exists for schistosomiasis. Even though anti-parasitic drugs and other control measures, including public hygiene and snail control are available, the advent of an effective vaccine still remains the most potentially powerful means for the control of this disease. Vaccination of individuals at a young age would be the most efficient way of priming the immune system without the accompaniment of egg-induced pathology. A vaccine would also prevent severe infection and thus decrease transmission of eggs and help curb the cycle of S. mansoni infection. Boosting of immunity to schistosomes in vaccinated individuals would occur following subsequent exposure to infective cercariae.
Several adult S. mansoni proteins have been considered as potential vaccine candidates. Ideally, the most promising vaccine candidates may be those which are surface-exposed and are indispensable for the parasite's survival within the human host.
A major problem that has hindered schistosomiasis vaccine research and development concerns the identification and selection of potential protective antigens encoded by the parasite. During the last two decades, many laboratories have attempted to identify schistosomal antigens that induce partially protective immune responses. More than 100 such antigens have been identified, about 25% of which confer protection of varying degrees. None of these candidate antigens, however, have induced levels of an immune response approaching immunity levels (˜80%) that have been observed following vaccination with irradiated schistosome larvae. Independent examination of the six “priority antigens” (paramyosin, glutathione S-transferase, fatty acid binding 14 kDa protein, IrV-5, triose phosphate isomerase, and Sm23) via a standard comparative World Health Organization delineated procedure, resulted in none of the antigens providing the stated goal of 40% protection or better.
Schistosomes interact closely with their host, performing functions such as immune evasion, nutrient uptake, and attachment. Host-exposed schistosome proteins that undertake such essential functions are effective targets for a schistosomiasis vaccine. One such protein is the large subunit of calpain (Sm-p80) which plays an important role in the surface membrane renewal of schistosomes, an immune evasion mechanism employed by blood-dwelling helminths to evade host immunity. Sm-p80 is exposed at the host parasite interface and is naturally immunogenic. While the natural immunogenicity of the molecule does not provide protection under conditions of natural infection, it is possible to present calpain to the immune system in such a way as to induce potent immunity. The UNDP/World Bank/WHO-TDR special panel designated Sm-p80 as one of the priority antigens “with established credentials, needing further development” and Sm-p80 is now considered as one of the “first-tier candidates” by international experts in the field.
An efficacious schistosomiasis vaccine would make a significant contribution to current schemes of disease control, particularly if it provides a potent, long-lasting immunity to the disease. Such a vaccine would greatly reduce the need for logistically difficult and expensive drug-based programs which often require political commitment and well-funded public health systems. Even partial protection against cercarial infection would be a significant advance because a vaccine that reduces worm burden will reduce both the pathology and the transmission rates of the disease. This is because schistosomes, unlike most other infectious organisms, do not replicate within their definitive hosts. Therefore, a sterilizing immunity may not be required for schistosomiasis. The Scientific Working Group on schistosomiasis at the World Health Organization (WHO) has determined that vaccines that lower adult worm burdens by 50% will be effective in reducing overall morbidity and mortality.
Most schistosome vaccine candidates confer 30-50% protection in the mouse model system. Thus, there is a great need to identify novel antigens, adjuvant vehicles, and cocktail vaccine formulations to induce protection that ranges from 70% to 80%, as has been recorded with radiation-attenuated vaccines.
The present invention proposes a novel vaccine formulation based on a schistosome protein, calpain, which was originally determined to be involved in schistosome surface membrane biogenesis. Calpain has two subunits, the larger of which, Sm-p80, has shown great potential as a relevant vaccine antigen for reduction of the morbidity associated with both Schistosoma mansoni and Schistosoma japonicum. 